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Positive Effect of Abdominal B reathing Exercise on<br />

Gastroesophageal Reflux Disease: A Randomized,<br />

Controlled Study. Am J Gastroenterol. 2011 Dec 6. By<br />

Eherer AJ, Netolitzky F, Högenauer C, Puschnig G,<br />

Hinterleitner TA, Scheidl S, Kraxner W, Krejs GJ,<br />

Hoffmann KM. from<br />

Division of Gastroenterology and Hepatology,<br />

Department of Internal Medicine, Medical University<br />

Graz, Graz, Austria.<br />

OBJECTIVES: The lower esophageal sphincter<br />

(LES), surrounded by diaphragmatic muscle, prevents<br />

gastroesophageal reflux. When these structures become<br />

incompetent, gastric contents may cause gastroesophageal<br />

reflux disease (GERD). For treatment, lifestyle<br />

interventions are always recommended. We hypothesized<br />

that by actively training the crura of the diaphragm as part<br />

of the LES using breathing training exercises, GERD can<br />

be positively influenced. METHODS: A prospective<br />

randomized controlled study was performed. Patients with<br />

non-erosive GERD or healed esophagitis without large<br />

hernia and/or previous surgery were included. Patients<br />

were randomized and allocated either to an active<br />

breathing training program or to a control group. Quality<br />

of life (QoL), pH-metry, and on-demand proton pump<br />

inhibitor (PPI) usage were assessed at baseline and after 4<br />

weeks of training. For long-term follow-up, all patients<br />

were invited to continue active breathing training and<br />

were further assessed regarding QoL and PPI usage after 9<br />

months. Paired and unpaired t-test was used for statistical<br />

analysis. RESULTS: Nineteen patients with non-erosive<br />

GERD or healed esophagitis were randomized into two<br />

groups (10 training group and 9 control group). There was<br />

no difference in baseline patient characteristics between<br />

the groups and all patients finished the study. There was a<br />

significant decrease in time with a pH

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